Individual
AMELIA HANNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
801 RIVER DR, FORT BRAGG, CA 95437-5404
(707) 964-8080
Mailing address
1197 PHEASANT HILL CT, SAN JOSE, CA 95120-5823
(408) 826-7356
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
110529
CA
Other
Enumeration date
08/10/2024
Last updated
08/10/2024
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